System and method for prevention of radiocontrast induced nephropathy

Abstract

An apparatus and method particularly useful in treatments and therapies directed at the kidneys such as the prevention of radiocontrast nephropathy (RCN) arising from diagnostic procedures using iodinated contrast materials. A series of treatment schemes are provided based upon local therapeutic agent delivery to the kidneys that can be used as a prophylactic treatment for patients undergoing interventional procedures that have been identified as being at an elevated risk for developing RCN as well as for low risk patients. The methods may include pre-exposure and post contrast exposure treatments alone or in combination with the local delivery of therapeutic agents to the kidneys. Among the agents identified for such treatments are normal saline and the vasodilators papaverine and fenoldopam mesylate and appropriate dosing is provided.

1 . A method for preventing radiocontrast induced nephropathy in a patient in response to delivering radiocontrast agent to the patient, comprising: 
 locally delivering a therapeutic dose of a renal therapy agent bi-laterally to the renal arteries of a patient during exposure to the radiocontrast agent; and    monitoring the renal function of the patient.    
   
   
       2 . A method as recited in  claim 1 , wherein said agent comprises a vasodilator.  
   
   
       3 . A method as recited in  claim 2 , wherein said vasodilator comprises fenoldopam mesylate or an analogue or derivative thereof.  
   
   
       4 . A method as recited in  claim 3 , wherein said therapeutic dose comprises an administration rate of between approximately 0.01 mcg/kg/min to approximately 3.2 mcg/kg/min.  
   
   
       5 . A method as recited in  claim 3 , wherein said therapeutic dose comprises an administration rate of between approximately 0.1 mcg/kg/min to approximately 0.2 mcg/kg/min.  
   
   
       6 . A method as recited in  claim 2 , wherein said vasodilator comprises a natriuretic He or an analogue or derivative thereof.  
   
   
       7 . A method as recited in  claim 6 , wherein said dose of papaverine is administered at a rate of between about 2 mg/min to about 3 mg/min.  
   
   
       8 . A method as recited in  claim 1 , wherein said agent comprises a hydrating agent, wherein said hydrating agent causes hydration of a patient over a normal baseline.  
   
   
       9 . A method as recited in  claim 8 , wherein said hydrating agent comprises normal saline.  
   
   
       10 . A method as recited in  claim 9 , wherein said therapeutic dose of normal saline comprises an administration rate of between about 20 cc/kg/hour to about 30 cc/kg/hour.  
   
   
       11 . A method as recited in  claim 9 , wherein said therapeutic dose of normal saline comprises an administration rate of between about 24 cc/kg/hour to about 26 cc/kg/hour.  
   
   
       12 . A method as recited in  claim 1 , wherein said renal function is monitored by periodically evaluating serum creatinine levels over time.  
   
   
       13 . A method for preventing radiocontrast induced nephropathy in a patient, comprising: 
 delivering a first therapeutic dose of a first renal therapy agent to the patient during a first period that is before exposure to a radiocontrast agent; and    locally delivering a second therapeutic dose of a second renal therapy agent bi-laterally to the renal arteries of the patient during a second period that is during exposure to the radiocontrast agent.    
   
   
       14 - 131 . (canceled)  
   
   
       132 . A bilateral local renal therapy system for protecting a renal system from radiocontrast nephropathy associated with delivery of a radiocontrast agent within a vascular system of a patient, comprising: 
 a catheter having a proximal end and a distal end;    a fluid agent source comprising a fluid agent, the fluid agent source coupled with the proximal end of the catheter via a fluid agent delivery port; and    first and second tips coupled with the distal end of the catheter, the first and second tips in fluid communication with the fluid agent delivery port, and configured for bilateral entry into renal arteries of the patient.    
   
   
       133 . The renal therapy system according to  claim 132 , wherein the fluid agent comprises saline.  
   
   
       134 . The renal therapy system according to  claim 132 , wherein the fluid agent comprises a vasodilator.  
   
   
       135 . The renal therapy system according to  claim 134 , wherein the vasodilator comprises a natriuretic or an analogue, derivative, or precursor thereof.  
   
   
       136 . The renal therapy system according to  claim 134 , wherein the vasodilator comprises fenoldopam or an analogue, derivative, or precursor thereof.  
   
   
       137 . The renal therapy system according to  claim 132 , further comprising: 
 a second fluid agent source comprising a second fluid agent, the second fluid agent source coupled with the proximal end of the catheter via a second fluid agent delivery port;    wherein the first and second tips are in fluid communication with the second fluid agent delivery port.    
   
   
       138 . The renal therapy system according to  claim 132 , further comprising an infusion pump.